Long-chain polyunsaturated fatty acids in preterm infants: Status at birth and its influence on postnatal levels,☆☆,,★★

https://doi.org/10.1016/S0022-3476(95)70363-2Get rights and content

Abstract

To determine the influence of the prenatal long-chain polyunsaturated fatty acid (LCP) supply on prenatal growth and on postnatal LCP levels, we studied 52 preterm infants and assessed the relations between the LCP status at birth (reflecting the prenatal LCP supply), gestational age and prenatal growth, and the relation between the LCP status at birth and at 37 to 42 weeks of gestational age. After a correction for gestational age at birth, significant relations (p ≤0.05) were observed between anthropometric measurements at birth (weight, head circumference, and length) and LCP levels in the umbilical artery wall, the LCP content of which reflects the long-term fetal LCP status. Independent of the neonatal diet (human milk or formula), LCP levels in erythrocyte phospholipids at term were positively related to levels in the umbilical artery wall (docosahexaenoic acid (22:6n-3): p ≤0.0003; arachidonic acid (20:4n-6): p = 0.02). Postnatal diet significantly influenced LCP levels in plasma phospholipids at term (docosahexaenoic acid: p ≤0.004; arachidonic acid: p = 0.02); formula-fed infants had lower values. We conclude that the LCP status of preterm infants at birth is related to prenatal growth. Moreover, next to the postnatal enteral diet, the LCP status at birth significantly affects LCP levels at term postconceptional age. This finding may warrant further studies of the effects of essential fatty acid-enriched maternal diets during pregnancy on the neonatal LCP status at birth. (J PEDIATR 1995;126:611-8)

Section snippets

Infants

The population studied comprised 52 preterm infants (GA, 26 to 36 weeks; birth weight, 650 to 1860 gm). The infants had no metabolic disease or congenital malformations. A 3 ml sample of venous cord blood and approximately 15 cm of umbilical cord were collected immediately after delivery to provide information on the LCP status at birth. This material was collected as part of a dietary study of preterm infants,9 which was approved by the medical ethics committee of the University Hospital of

Relation between LCP status at birth and GA at birth

In Table II, mean values for the fatty acids studied (percentage [wt/wt] and total amounts of PL-associated fatty acids) are listed. Birth weights of eight infants were at less than the 2.3rd percentile of the Amsterdam growth charts.27 These small-for-gestational-age infants were not included in the analyses of the relations among LCP status, GA, and anthropometric measurements at birth. No umbilical cord sample was available from 6 of the remaining 44 infants, and no acceptable blood sample

DISCUSSION

One of the objectives of this study was to enhance the knowledge of the relations between the LCP status at birth, GA at birth, and anthropometric measurements. The GA was positively correlated with relative n-3 LCP amounts in cord plasma PLs and with relative n-6 and n-3 LCP amounts in the umbilical artery walls. We consider the higher n-6 and n-3 levels observed with advancing GA to be an indication of an adequate response to the increasing demand for n-6 and n-3 LCPs, which are necessary for

References (38)

  • N Salem et al.

    Docosahexaenoic acid: membrane function and metabolism

  • SE Carlson et al.

    Visual-acuity development in healthy preterm infants: effect of marine-oil supplementation

    Am J Clin Nutr

    (1993)
  • KS Bjerve et al.

    Omega-3 fatty acids: essential fatty acids with important biological effects, and serum phospholipid fatty acids as markers of dietary omega-3 fatty acid intake

    Am J Clin Nutr

    (1993)
  • SJ Fliesler et al.

    Chemistry and metabolism of lipids in the vertebrate retina

    Prog Lipid Res

    (1983)
  • ML Pita et al.

    Changes in the fatty acids pattern of red blood cell phospholipids induced by type of milk, dietary nucleotide supplementation, and postnatal age in preterm infants

    J Pediatr Gastroenterol Nutr

    (1988)
  • B Koletzko et al.

    Effects of dietary long-chain polyunsaturated fatty acids on the essential fatty acid status of premature infants

    Eur J Pediatr

    (1989)
  • MMHP Foreman-van Drongelen et al.

    Long-chain polyene status of preterm infants with regard to the fatty acid composition of their diet: comparison between absolute and relative fatty acid amounts in plasma and red blood cell phospholipids

    Br J Nutr

    (1995)
  • CJ Lammi-Keefe et al.

    Lipids in human milk: a review. II. Composition and fat-soluble vitamins

    J Pediatr Gastroenterol Nutr

    (1984)
  • RG Jensen et al.

    Lipids in human milk and infant formulas

    Ann Rev Nutr

    (1992)
  • Cited by (73)

    • Fatty acids in the placenta of appropiate- versus small-for-gestational-age infants at term birth

      2021, Placenta
      Citation Excerpt :

      In the placenta, a similar fatty acid profile was observed between normal and restricted groups, but the proportion of fatty acids of the linoleic acid series (n6) and the conversion ratio of DHA from its precursor LA (n3) was significantly lower in the restricted placenta compared to the normal placenta [28,31]. Several studies in premature infants showed that smaller size at birth was related to lower EFA concentrations in the infant [32–35]. Knowledge about the fatty acid composition and the activity of the desaturase and elongase enzymes in placentas from SGA term neonates is scarce.

    • Fatty acids and early human development

      2007, Early Human Development
    View all citing articles on Scopus

    From the Departments of Human Biology and of Methodology and Statistics, University of Limburg, Maastricht, The Netherlands, and the Departments of Obstetrics and Gynecology and of Neonatology, University Hospital Maastricht, Maastricht, The Netherlands

    ☆☆

    Supported by a grant from Nutricia, Zoetermeer, The Netherlands.

    Reprint requests: Magritha M. H. P. Foreman-van Drongelen, MD, Department of Human Biology, University of Limburg, PO Box 616, 6200 MD Maastricht, The Netherlands.

    ★★

    0022-3476/95/$3.00 + 0 9/23/61096

    View full text